Annual Report January - December 2021

Los Angeles County COMMISSION ON ALCOHOL AND OTHER DRUGS

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TABLE OF CONTENTS

2 Commission on Alcohol & Other Drugs Commissioners by Supervisorial District

3 Commission on Alcohol & Other Drugs Mission Statement and Ordinance

5 Key Issues Impacting At-Risk and Systems- Involving Alcohol and Other Drugs

6 Strategic Priorities for 2021

Strategic Priority 1: Substance Use Disorder Treatment Efficiency and Recidivism

Strategic Priority 2: Marijuana Education and Regulation

Strategic Priority 3: Opioids and Heroin Addiction

Strategic Priority 4: Co-occurring Disorders & Integration of Services

Strategic Priority 5: Sober Homes and Transitional Living

Strategic Priority 6: Homeless Populations and Youth

7 Commission on Alcohol and Other Drugs Meetings

Education and Prevention Committee

Policy and Planning Committee

Commission Recommendations

12 Commission on Alcohol & Other Drugs Strategic Partnerships

Commissioner Representation on other County/Community Bodies

Los Angeles County Department of Public Health - Substance Abuse Prevention and Control

20 Commission on Alcohol and Other Drugs 2021 Accomplishments

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COMMISSION ON ALCOHOL AND OTHER DRUGS COMMISSIONERS BY SUPERVISORIAL DISTRICT

JANUARY 2021 – DECEMBER 2021

COMMISSION OFFICERS Lou La Monte, Chair

Monica Sanchez, First Vice Chair Deena Duncan, Second Vice Chair

Sharona R. Nazarian, Recording Secretary Tony Bell, Member-At-Large Cruz Baca, Member-At-Large

COMMISSION ASSISTANT

Ronae Harrison FIRST SUPERVISORIAL DISTRICT SUPERVISOR HILDA L. SOLIS Cruz Baca Jack Hadjinian Bennett W. Root, Jr. Jerry G. Velasco

SECOND SUPERVISORIAL DISTRICT SUPERVISOR Holly J. Mitchell Johng Ho Song Vacant (as of September 2018) Vacant (as of September 2019) Vacant (as of December 2020)

THIRD SUPERVISORIAL DISTRICT SUPERVISOR SHEILA KUEHL Amanda Cowan (appointed September 2021) Sharona R. Nazarian Mark Ryan (appointed January 2021) Denise Tom (served until January 2021) Wendie Warwick FIFTH SUPERVISORIAL DISTRICT SUPERVISOR KATHRYN BARGER Tony Bell Jozef Essavi Roger Gertmenian (served until January 2021) Gino Roncelli (appointed April 2021) Howard L. Winkler

FOURTH SUPERVISORIAL DISTRICT SUPERVISOR JANICE HAHN Deena Duncan Jihan Judeh Juan Navarro (reappointed February 2021) G. Lola Worthington COUNTYWIDE CRIMINAL JUSTICE COORDINATION COMMITTEE Jeremiah Hart (appointed December 2021) LEAGUE OF CALIFORNIA CITIES LOS ANGELES DIVISION Lou La Monte SUBSTANCE ABUSE PREVENTION AND CONTROL Monica Sanchez

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COMMISSION ON ALCOHOL AND OTHER DRUGS MISSION STATEMENT AND ORDINANCE

MISSION STATEMENT

The Commission on Alcohol and Other Drugs (CAOD) advises and makes recommendations to the Board on alcohol and drug issues with the goal of reducing problems and the negative impact of substance use disorders on the quality of life for individuals and their families residing in Los Angeles County. ORDINANCE The Commission, as an advisory board, is established pursuant to California Health and Safety Code Sections 429.997, 11752.1(e), 11798.1(a), 11805 and 11998.1(f)(2). The Commission functions pursuant to Chapter 3.15 of the Los Angeles County Code; Board Order Nos. 10 of January 19, 2010, 55 of January 19, 2010, 64-B of January 19, 2010, 19 of January 26, 2010, Ordinance No. 2010-0003 (Which consolidated the Commission on Alcoholism and the Narcotics and Dangerous Drugs Commission and repealed Chapters 3.06 and 3.40), and Board Order No. 125 of June 26, 1990, Ordinance No. 90-0086 (Term Limits); Board Order No. 31 of April 6, 2010, and Ordinance No. 2010-0016. Board Order No. 38 of October 19, 2010, Ordinance No. 2010-0046. The Commission is charged by its ordinance to:

• Review federal, state and local legislation and recommend to the Board appropriate measures for the implementation thereof

• Recommend to the Board a stronger program, including federal, state, and local legislation as in its opinion would be advisable

• Recommend to the Board strong programs in the field of enforcement, medication, prevention, and rehabilitation concerned with problems associated with the abuse of and addiction to alcohol and other drugs

• Advise the County Substance Abuse Prevention and Control Administrator on goals and policies of the County Substance Abuse Prevention and Control Administration and on any other related matters the County Substance Abuse Prevention and Control Administrator refer to it or which are raised by the Commission

• Organize and assist in alcohol and other drug conferences in areas of the County • Encourage and educate the public to understand the nature of addiction to alcohol and

other drugs and related problems, and encourage support throughout the county for development and implementation of effective programs for prevention and treatment of alcohol and other drug abuse, addiction and related problems

• Do all other things necessary or helpful to reduce the illicit and problematic use of alcohol and other drugs

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For over a decade, the Commission has served as both a forum for discussion of new or emerging circumstances regarding use and regulation of alcohol and other drugs with the County and as a staunch advocate for prevention and treatment programs for substance use disorders for all communities within Los Angeles County. In doing so, the Commission has been committed to strengthening and supporting a system of integrated services, inclusive of both public and private partners, to provide thorough policy, planning, education, recovery, and prevention services designed to address and reduce problems and the negative impact of alcohol and other drug use on the quality of life of children, youth and adults in Los Angeles County.

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KEY ISSUES IMPACTING AT-RISK AND SYSTEMS-INVOLVING ALCOHOL AND OTHER DRUGS

For our Commission, as well as others in 2021, difficulties were presented by the occurrence of the Covid-19 pandemic and the challenges throughout the County resulting from necessary public health measures. Traditionally, the Commission starts the new year by considering and adjusting its strategic priorities to what are the most important issues that will face our communities in the coming years. However, despite these difficulties we welcomed four new Commissioners during this reporting period and are anticipating 3 additional commissioners to complete our roster. These shifts in composition have increased diversity in thought and experience. This will help us to complete our mission of informing the BOS concerning issues plaguing our communities. Substance use disorders and the conditions that lead to alcohol and drug addictions were aggravated by isolation during the pandemic. Preliminary data showed that depression, use of alcohol and drugs increased as the year progressed. Abuse of pain medications such as opioids and street drugs, and overdoses with fentanyl laced substances increased dramatically. The Commission is tightly integrated with the Los Angeles County Department of Public Health’s Substance Abuse and Prevention Control (SAPC), the principal agency within the County authorized to create and maintain County programs designed to assist in the prevention of alcohol and drug related problems and to coordinate and support County efforts to provide treatment and recovery options for its residents confronting alcohol and drug issues and substance use disorders. The CAOD adopted and enacted a new strategic plan with a focus on prevention. To that end, we adopted a new Strategic Prevention Framework (SPF). The SPF six step planning process guides the development of prevention services. The following is a list of our strategic priorities and how we informed and educated the commission in each of these areas. COAD’s strategic plan focused on six Priority Areas, including:

• Priority 1: Substance Use Disorder Treatment Efficiency and Recidivism • Priority 2: Marijuana Education and Regulation • Priority 3: Opioids and Heroin Addiction • Priority 4: Co-occurring Disorders & Integration of Services • Priority 5: Sober Living Homes and Transitional Living Homes • Priority 6: Homeless Populations and Youth

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STRATEGIC PRIORITIES FOR 2021 STRATEGIC PRIORITY 1: SUBSTANCE USE DISORDER TREATMENT EFFICIENCY AND RECIDIVISM The Commission will focus on three goals, including:

• Goal 1: To ensure and improve the efficiency of the current County programs at reducing Substance Use Disorders, reducing recidivism and assisting with County homeless populations.

• Goal 2: Determine what is the substance use disorder’s recovery success and determine what are the best metrics for appropriate measurement.

• Goal 3: Improve strategies involving MAT (medically assisted treatment) and needle exchange, safe injection sites, and other harm reduction methodologies.

STRATEGIC PRIORITY 2: MARIJUANA EDUCATION AND REGULATION The Commission will focus on three goals, including:

• Goal 1: Be cognizant of all current and pending cannabis legislation and the effects throughout Los Angeles County, including our underserved communities.

• Goal 2: Assist with preventative efforts surrounding the legalization of recreational marijuana, especially to our children and youth.

• Goal 3: Determine whether the current tax structure is effective in encouraging compliance.

STRATEGIC PRIORITY 3: OPIOIDS AND HEROIN ADDICTION The Commission will focus on two goals, including:

• Goal 1: Ensure increased awareness and promotion of programs to treat meth and opioid addiction.

• Goal 2: Work collaboratively with the Board of Supervisors (BOS), other commissions, County staff and others to share information and resources regarding the opioid crisis.

STRATEGIC PRIORITY 4: CO-OCCURRING DISORDERS & INTEGRATION OF SERVICES The Commission will focus on five goals, including:

• Goal 1: Determine how the Commission can improve and increase collaboration with diversion programs.

• Goal 2: Advocate for improved preventive efforts and effective programs for young people

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across the County of Los Angeles and determine if there is a tracking system available. • Goal 3: Determine the cost effectiveness of long-term recovery models and lifelong

program connections by examining other jurisdiction models to replicate and incorporate their ideas.

• Goal 4: Ensure effective treatment is available to the men, women and children of Los Angeles County.

• Goal 5: Support the integration of SAPC’s well-being centers throughout the County which will provide mental health and other support services to those suffering from SUDs and their families and friends.

STRATEGIC PRIORITY 5: SOBER LIVING HOMES AND TRANSITIONAL LIVING HOMES The Commission will focus on two goals, including:

• Goal 1: Examine options for State, County and local regulations (and review federal regulations) to help ensure unlicensed sober living homes are safe for patients and communities.

• Goal 2: Make recommendations as needed to the County BOS regarding safe and effective sober living and transitional living facilities for the patients and communities of Los Angeles.

STRATEGIC PRIORITY 6: HOMELESS POPULATIONS AND YOUTH The Commission focused on two goals:

• Goal 1: Make recommendations to SAPC as needed as they continue to refine and enhance the benefit package available to the clients of Los Angeles County.

• Goal 2: Examine options for State, County and local regulations regarding Sober Living,

Transitional Housing and Bridge Housing to help ensure the best possible outcomes for maintaining sobriety and reducing recidivism in clients.

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COMMISSION ON ALCOHOL AND OTHER DRUGS MEETINGS Commission meetings are the primary vehicle through which information regarding alcohol and other drug related issues in Los Angeles County is disseminated and the venue at which policy matters are considered and recommendations are developed. During 2021, the Commission held 11 regular meetings during which reports, and presentations were given in alignment with our strategic goals by County departments, advocates and stakeholders on SUD related issues, services and programs were provided. The meeting topics included: Relapsing Left and Right’ Trying to Overcome Addiction in a Pandemic Joseph Friedman and Morgan Godvin Authors of the Los Angeles Times article Overview of the Drug Enforcement Administration Gail Parker, M.Ed. Community Outreach Specialist of Drug Enforcement Administration Public Health Video Address Dr. Barbara Ferrer Director of the County of Los Angeles Public Health Office Overview of the City of Los Angeles Department of Cannabis Regulation Cat Packer Executive Director of the City of Los Angeles Department of Cannabis Regulation Overview of the Los Angeles County District Attorney’s Office George Gascón District Attorney Los Angeles County District Attorney’s Office Prevention in Education Discussion Dr. Mark Ryan Commissioner Commission on Alcohol & Other Drugs Statistical Data Tina Kim, Ph.D, MA Chief, Health Outcomes & Data Analytics of Substance Abuse Prevention and Control

Impact of COVID-19 on Behavioral Health Dr. Jeremy Martinez Associate Medical Director for Co-occurring Disorders and Homeless Outreach and Engagement Los Angeles County Department of Mental Health Overview of the Office of Diversion and Reentry Peter Espinoza Retired Los Angeles Superior Court Judge & Director of the Office of Diversion and Reentry for Los Angeles County’s Department of Health Services. Substance Abuse Prevention and Control Annual Address Dr. Gary Tsai Director of Substance Abuse Prevention and Control County of Los Angeles Department of Public Health Report from Substance Abuse Prevention and Control Michelle Gibson, MPH Deputy Division Director for Treatment Services of Substance Abuse Prevention and Control Health Deputy Roundtable Health Deputy Anthony Cespedes - 1st District Assistant Health Deputy Jessica Jew – 2nd District Health Deputy Katie Butler – 3rd District Health Deputy Elan Shultz – 4th District Health Deputy Anders Corey – 5th District

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The Commission also has two active committees that meet prior to the general meeting. These include the Education and Prevention Committee and the Policy and Planning Committee. The topics discussed during 2021 include: EDUCATION AND PREVENTION COMMITTEE

• Regulation impacting the Youth – Commissioner Tony Bell • Prevention in Education – Commissioner Dr. Mark Ryan • Substance Use and Prevention/Youth Development Efforts - Commissioner Monica

Sanchez • District Attorney’s Office Outreach Program Project LEAD – Kerry Bigornia, Armina

Kesablyan and Keri Doggett • FASD Network of Southern California - Annette Kunzman • Baldwin Park Unified School District – Dr. Froilan Mendoza

POLICY AND PLANNING COMMITTEE • AB 71 (Rivas): Homelessness funding:

Bring California Home Act • AB 77 (Petrie-Norris): Substance use

disorder treatment services • AB 273 (Irwin): Cannabis: advertisements:

highways • AB 376 (O'Donnell): Alcoholic beverages:

licenses: arts and crafts workshops • AB 381 (Davies, Petrie-Norris): Licensed

facilities: duties • AB 638 (Quirk-Silva): Mental Health

Services Act: early intervention and prevention programs

• AB 644 (Waldron): California MAT Re-Entry Incentive Program

• AB 666 (Chiu): Substance use disorder workforce development

• AB 929 (Rivas): California Health Benefit Exchange: data collection

• AB 1242 (Bauer-Kahan): Alcoholic beverages: bona fide public eating place: off-sale privileges

• H.R. 706 (Rep. Kuster): Emergency Support for Substance Use Disorders Act

• H.R. 1996 (Perlmutter, D-CO): SAFE

Banking Act of 2021 • H.R. 2611 (Napolitano, D-CA): Increasing

Behavioral Treatment Act • S 987 (Sen. Portman): CARA 3.0 Act of

2021 • SB 57 (Wiener): Controlled substances:

overdose prevention program • SB 73 (Wiener): Probation: eligibility:

crimes relating to controlled substances • SB 110 (Wiener): Substance use disorder

services: contingency management • SB 220 (Skinner): Craft distillers: direct

shipping • SB 221 (Wiener): Health Care Coverage:

Timely Access to Care • SB 314 (Wiener): Alcoholic beverages • SB 389 (Dodd): Alcoholic beverages: retail

off-sale license: retail off-sale delivery • SB 421 (Bradford) Vehicles: driving under

the influence of alcohol and drugs • SB 519 (Wiener) Controlled substances:

decriminalization of certain hallucinogenic substances

• SB 783 (Bradford) Vehicles: driving under the influence of alcohol and drugs

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COMMISSION RECOMMENDATIONS Due to the seriousness of the impact of the necessary Covid-19 restrictions on people and programs dealing with substance abuse and addiction issues, the Commission recommends again to the Board of Supervisors that budget cuts occasioned by the pandemic in the County budget not be administered across-the-board to include SAPC’s budget, so that existing departmental programs could be maintained even as SUD recovery issues facing County residents are likely to increase as a result of public health measures necessary to control spread of the pandemic. During 2021 the Policy and Planning committee after a lengthy examination of SB 519 made a recommendation to the full Commission on Alcohol and Other Drugs which voted unanimously on the following formal resolution to the Board of Supervisors concerning this legislation:

WHEREAS, SB 519 authored by Senator Scott Wiener (D-San Francisco) would decriminalize psychedelic substances such as psilocybin, MDMA, LSD, ketamine, DMT and mescaline – furthering the potential for abuse that may lead to psychological problems, injury and death -- particularly among young people, and WHEREAS, the National Institute on Drug Abuse says hallucinogens work by temporarily disrupting communication between brain chemical systems throughout the brain and spinal cord. Some hallucinogens interfere with the action of the brain chemical serotonin, which regulates mood, sensory perception, sleep, hunger, body temperature, sexual behavior and intestinal muscle control. Dissociative hallucinogenic drugs interfere with the action of the brain chemical glutamate, which regulates pain perception, responses to the environment, emotion, learning and memory, and WHEREAS, the United States Drug Enforcement Administration classifies some hallucinogenic drugs such as lysergic acid diethylamide (LSD) as Schedule I drugs, substances, or chemicals which are defined as drugs with no currently accepted medical use and a high potential for abuse, and WHEREAS, a recent report by the Journal on Studies of Alcohol and Drugs found that adolescents in California are now more likely to use marijuana than they were prior to its decriminalization that there was an 18% increase in the likelihood of life time use. This portends that legalizing psychedelic drugs, which are far more impairing than alcohol or marijuana, would result in exponentially more added negative statistics, and WHEREAS, drug abuse also results in increased public costs for medical care, criminal justice costs, lost productivity, as well as serious injuries and other

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expenditures including impacts on welfare, trauma and emergency care, and foster care systems, and WHEREAS, the medical benefits and/or therapeutic use of psychedelic drugs studied in a scientific and targeted environment for mental health applications by doctors for disorders and post-traumatic stress disorder may have medical merit, legalizing for personal and recreational use would add to the abuse/addiction crisis, and WHEREAS, this is a public health and safety issue and legalization would vastly increase the potential for misuse and have a detrimental impact on our state, our county and our communities. NOW THEREFORE, BE IT RESOLVED, that to reduce public health and safety concerns, the Commission on Alcohol and Other Drugs recommends that the Los Angeles County Board of Supervisors oppose SB 519.

Link for more information concerning SB 519.

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COMMISSION ON ALCOHOL AND OTHER DRUGS STRATEGIC PARTNERSHIPS

The Commission maintains a critical and distinct role in Los Angeles County. As advisors to the Board, and advocates for those with SUDs and their families, the Commission often serves as a bridge between the County and its partners, including the County service agencies, law enforcement, courts, philanthropy, the nonprofit sector, and the community. The Commission’s experience, expertise and steadfast commitment to at-risk children, youth and adults has contributed to the forging of strong partnerships with some of the most important entities shaping public policy in Los Angeles County. COMMISSIONER REPRESENTATION ON OTHER COUNTY/COMMUNITY BODIES Cruz Baca Board Member St John the Baptist Catholic Church in Baldwin Park,

Social Services Board Member St John the Baptist St Vincent de Paul Baldwin Park President Baldwin Park Woman's Club Board Member Foothill Unity Center, Monrovia

Amanda Cowan MAT Community Advisory Board Prevention & Education in Communities of Color Grant UCLA- ISAP Community Advisory Board (CAB) for the Clinical Trials Network (CTN) Project

Deena Duncan California Association of Alcohol and Drug Program Executive SAPC Advisory Committee

Jozef Essavi Small Business Commission

Lou La Monte Board of Meals on Wheels West Past President of California Contract Cities Association

Juan Navarro Juvenile Justice Coordinating Council Board member of the California Association of Alcohol and Drug Program Executives Board member of the PIH Health – Community Benefit Oversight Committee

Dr. Sharona R. Nazarian

President for the Rotary Club of Beverly Hills Public Works Commissioner for Beverly Hills USC Hillel Executive Board Co-President of Beverly Hills Sister City

Bennet W. Root, Jr Los Angeles County Mental Health Commission

Monica Sanchez LA County Meth Task Force Prevention Committee

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LA County Rethinking Access to Marijuana Policy Committee California Alcohol Policy Alliance Committee Southeast Area Social Services Funding Agency Board Pico Rivera City Council, Mayor UCLA Alumni Association Board of Directors, Southeast

Johng Ho Song QueensCare Charitable Foundation Board

Jerry Velasco Mexican American Opportunity Foundation San Gabriel Valley Civic Alliance El Monte Promise Foundation

Wendie Warwick Al-Impics Planning Committee

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LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH SUBSTANCE ABUSE PREVENTION AND CONTROL The Commission works closely with the Los Angeles Department of Public Health (DPH) and particularly with Substance Abuse Prevention and Control (SAPC) and participates annually in the Al-Impics event. During this second year of the public health emergency, DPH-SAPC continued its steadfastly committed work in implementing prevention, harm reduction and treatment programming to further DPH’s mission of advancing the conditions that support optimal health and well-being for all. Through its prevention efforts, DPH-SAPC works with organizations, residents, and communities to foster community change and create environments that limit the negative impacts of alcohol and other drugs, particularly on youth and disproportionately impacted communities. The division’s harm reduction work connects staff to individuals that may not be ready for treatment but can still be engaged in services that promote their health and well-being. The treatment arm facilitates the delivery of a range of quality, medically necessary substance use disorder treatment services to Medi-Cal and My Health LA (MHLA) patients and other safety net populations, such as justice-involved youth and adults in community supervision (AB 109). Network providers have remained open during the public health emergency to ensure that people that need substance use services can access them. Despite the challenges faced due to increases in substance use, addiction, and overdose; there are critical opportunities ahead that will increase the division’s capacity to address these and future challenges. The following are highlights about new programs and initiatives implemented throughout this year or are in preparation for launch, all which aim at helping Los Angeles County residents either enter or continue navigating their road to recovery. 2021 milestones and highlights: Student Wellbeing Centers In December of 2019 DPH-SAPC partnered with the Los Angeles Unified School District, Department of Mental Health and Planned Parenthood of Los Angeles to host Student Wellbeing Centers (WBCs) at various campuses throughout the District. The centers offer services to educate students in high need neighborhoods about lifelong protective practices by addressing substance abuse prevention and control measures, reproductive health, social/emotional well-being, and youth leadership. Since that time, the WBCs has helped more than 200 students through participation in virtual leadership programming, 1,103 students in DMH sessions, more than 300 parents in virtual trainings, and in the last quarter alone, 1,358 teens accessed services through the telephone hotline. As of last month, all in person services resumed at 10 WBCs throughout LAUSD.

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Tuition Incentive Pilot (TIP) Program July 2021 DPH-SAPC launched its Tuition Incentive Pilot (TIP) Program in 2020. Through this pilot, 101 participants became Registered SUD counselors and 81 completed the necessary coursework to become Certified SUD Counselors. The pilot ended this July with seventeen participants having completed their required internships hours. The remaining participants are still accruing experience hours through employment or internships and working towards full certification. Another successful component was establishing collaborative partnerships between network providers, DHCS-approved certifying organizations and trainers from the California Institute for Behavioral Health Solutions (CIBHS). Youth System of Care Learning Management System DPH-SAPC collaborated with Azusa Pacific University to launch the Youth System of Care Learning Management System (LMS) that includes trainings for providers who deliver services to youth (12-17) and young adults (18-20). The LMS is accessible at www.YouthSystemofCare.com and contains 13 modules that address youth-specific topics such as guidance on determining medical necessity, developing therapeutic alliance, application of evidence-based practices, addressing the needs of youths with co-occurring disorders, and other topics. Continuing Education (CEs) credits are available for each module. Since launch, 410 users have registered for trainings on LMS and have completed 958 modules and been awarded 290 CEs Credits. In 2021, the LMS has been expanded to include five additional modules focusing on Family-Based Services, Multicultural Competence & Cultural Humility, Pharmacology of Stimulants, Co-Occurring Disorders, and Clinical Supervision. Launched the second “Meth Free LA County” Awareness Campaign January- March 2021 and July 2021 – October 2021 In efforts to further address the continued rise in methamphetamine emergency room visits, hospitalizations and deaths in Los Angeles County, DPH-SAPC launched two campaigns.

1. Created as a follow-up to the initial Meth Free LA County media campaign, DPH SAPC launched a 7-week social media campaign focused on reminding Los Angeles County of the signs of methamphetamine use and how they can get help. SAPC-contracted prevention providers as well as its media vendor, promoted methamphetamine prevention and treatment messages through weekly Facebook, Instagram, and posts.

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2. Developed and launched a three-month comprehensive media campaign, focused on three different audiences: agents of change (video, social media posts, strategically placed digital banners), men who have sex with men (video, social media posts, and strategically placed digital billboards), and people experiencing homelessness (informational postcards, posters and junior billboards). The campaign was intended to educate on the signs and impact of methamphetamine, acknowledge how hard it is to quit, and provide harm reduction strategies to promote less use and improved health. The campaign was executed in both English and Spanish. Evaluation of the campaign’s success is currently being finalized. The videos and information from the campaign can be viewed on the MethFreeLACounty.org website.

MAT Works February 2021 DPH-SAPC launched the second of a two-part campaign for the Medications for Addiction Treatment (MAT) Awareness which included the development of the MatWorks.org website. The first part of the campaign was the distribution of MAT posters in November 2020 that DPH-SAPC SUD treatment providers were required to post in their waiting rooms to empower clients to ask about MAT options. The second component was developed to provide the public with a general overview about MAT, medication types, common myths, and how to access MAT services in Los Angeles County. The MATWorks link is also incorporated into the RecoverLA.org app which launched in April 2021 and the media campaign launched in May 2021. Expansion of SUD treatment services in STRTPs February 2021 Los Angeles County convened a Task Force to develop recommendations for improving care for youth residing in Short-Term Residential Therapeutic Programs (STRTPs). DPH-SAPC collaborated with the Department of Children Family and Family Services (DCFS) and Department of Mental Health (DMH) to develop a multi-pronged approach to expanding SUD services for youth in STRTPs. DPH-SAPC contributed to the development of a concept paper to serve youth in STRTP settings, expanded on-site field-based treatment services at some STRTPs, facilitated meetings between STRTPs and SUD providers to enhance collaboration and service referrals between the networks, and provided SUD 101 and overdose prevention training to STRTP staff.

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Law Enforcement Assisted Diversion (LEAD) Program April 2021 DPH-SAPC collaborated with Department of Health Services’ Office of Diversion and Reentry (DHS-ODR) to establish CENS services in the East Los Angeles LEAD program in Service Planning Area (SPA) 7. CENS services are co-located at the host agency, Alma Family Services (DHS-ODR contractor). The LEAD program is a community-based diversion approach to improve public safety and reduce unnecessary justice system involvement for those who participate in the program. CENS services are provided onsite at Alma Family Services, as well as in the field as part of their multidisciplinary outreach team in SPA 7. Mainstream Services Integration April 2021 Integration of County services began in April 2021 and the Los Angeles Homeless Services Authority (LAHSA) anticipates approximately 70 interim housing sites will need County Mainstream Services Integration. SUD services are primarily provided by CENS, but may be provided by the Substance Abuse Service Helpline (SASH), when appropriate (i.e. Safe Parking sites). CENS SUD services include screening and referrals to SUD treatment, syringe exchange programs (SEPs) and medications for addiction treatment (MAT). Recover LA May 2021 DPH-SAPC launched its mobile-friendly community-facing SUD resource guide, Recover LA (www.RecoverLA.org). Recover LA provides information on substance use and misuse; harm reduction options; treatment options; medications for addiction treatment (MAT); information on the county’s 24/7 treatment access line; patient rights and confidentiality; and other resources. The guide's purpose is to facilitate LA County residents' ability to find and access the SUD prevention, harm reduction, and treatment resources available to them and their loved ones. Recover LA also includes a mobile-friendly version of DPH-SAPC's existing Service and Bed Availability Tool treatment locator and is available in thirteen languages. Alternatives to Incarceration’s Rapid Diversion Program (ATI-RDP) May 2021 DPH-SAPC began discussions with the Department of Mental Health (DMH) to partner with on the Alternatives to Incarceration Initiative (ATI) – Rapid Diversion Program (RDP) to provide substance use disorder screening and connection to services through the CENS program at three existing co-located courthouses: Antelope Valley, Van Nuys, and Clara Shortridge Foltz Criminal Courts Building. ATI-RDP is a pre-plea diversion program targeting individuals with a mental health and/or SUD diagnosis. Individuals in this program are identified by the Court, screened by a mental health clinician, and referred to co-located CENS counselors for SUD

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services, as appropriate. Cases are dismissed for individuals who successfully complete the program. In August 2021, DPH-SAPC was notified that the Care First Community Investment (CFCI), also known as Measure J, funding was approved to support CENS services. Client Engagement and Navigation Services (CENS) At Juvenile Halls July 2021 The CENS program for Juvenile Justice-Involved Youth and Young Adults is an intensive pilot program intended to facilitate access to SUD treatment among youth (12-17) and young adults (over 18) at juvenile halls in LA County. The CENS will collaborate with Probation to provide on-site SUD screenings and connect youth to a continuum of SUD treatment services including prevention, outpatient, intensive outpatient and residential treatment programs, and recovery supportive services in the community upon their release. CENS will serve as a resource hub for participating youth throughout their treatment while residing in the halls and as they return and reintegrate into the community. In-person CENS services were implemented at Barry J. Nidorf juvenile hall in July and at Central Juvenile Hall in November of 2021. Al-Impics September 17, 2021 DPH-SAPC sponsored the annual SUD awareness and recovery sports event, known as the Al-Impics. The 2021 Al-Impics event, planned and implemented in partnership with Special Services for Groups, the Al-Impics Planning Committee, and iHeartMedia, brought together individuals in treatment and recovery, their families and local leaders/community members, to join in the spirit of healthy competition to demonstrate that “Treatment Works and Recovery is Possible.” The Al-Impics was presented as a virtual event at no cost to the participating agencies. The 2021 Al-Impics theme was “Erase the Stigma and Embrace the Change”. The Al-Impics was broadcast on the AM570 and REAL 92.3 websites and can still be accessed on the Los Angeles Al-Impics website. Danny Trejo, Fred Roggin and Big Boy (host of Big Boy’s Neighborhood on REAL 92.3 FM) once again served as hosts and guest speakers, along with SAPCs Division Director, Dr. Gary Tsai, sharing their stories of hope. SUD Availability Dashboard November 2021 DPH-SAPC launched the Service and Bed Availability Dashboard for its treatment network to provide timely information on indicators such as average daily bed availability, intake slot availability, and timeliness of availability updates. This information will make it easier for providers, referral partners and patients to quickly identify agencies and sites within the provider network who can accept patients when they are ready to enter into care. The dashboard greatly enhances our existing process for connecting county residents, including those who are experiencing homelessness, to available treatment in a timely manner. As a result, the public and referral partners can quickly and accurately refer and place persons seeking treatment.

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Recovery Bridge Housing (RBH) RBH is a recovery oriented, peer supported interim living environment for those concurrently engaged in outpatient SUD treatment. Priority for RBH given to homeless adults, including the justice involved, TAY, HIV/AIDS, and perinatal populations. During calendar year 2021, DPH-SAPC applied for CFCI, the Coronavirus Response and Relief and Supplemental Appropriations Act (CRRSAA), and the American Rescue Plan Act funding to expand our network of RBH agencies and locations. Approval of $2 million of CFCI funding and 1.8 million of CRRSAA/ARPA funding will expand the current total RBH bed capacity of 987 by an additional 200 beds at existing and new sites to serve individuals and parents with children. Facilitating Access to Medically Necessary Substance Use Disorder (SUD) Treatment Services DPH-SAPC Quality Improvement and Utilization Management (QI & UM) staff reviewed over 66,000 member authorizations submitted from the DPH-SAPC provider network. QI & UM prioritized reviewing inpatient withdrawal management authorizations in Sage (the LA County SUD electronic health record) to ensure that these treatment services were available to LA County residents. Provider Support and Health Program Improvement The Provider Support and Health Program Improvement Unit worked in collaboration with SAPC units and the Department of Health Services to implement the Housing for Health – Enriched Residential Care program (HFH-ERC). The program offers on-site SUD treatment, at Adult Residential Facilities (ARF) and Residential Care Facilities for the Elderly (RCFE). These Field-Based Services (FBS) target hard to reach populations, including people experiencing homelessness, those who are medically fragile and psychiatrically vulnerable. To date, services have been initiated at four facilities. Unit staff are actively working to connect an additional six facilities with interested SAPC SUD provider agencies and finalize the FBS application and approval process. Essential Access Health Collaboration DPH-SAPC contracted with Essential Access Health to coordinate seven instructor-led comprehensive reproductive health trainings to our Pregnant and Parenting Women (PPW) network of treatment providers across the county. The goal of the collaboration is to train up to two-hundred eighty (280) SUD treatment provider staff. It is designed to be a patient-centered shared-decision making model to be used with patients of any demographic without judgement. This training is part of SAPC’s work toward integrating sexual and reproductive health needs of women in SUD treatment settings and ensuring that women receive appropriate referrals to family planning and other services.

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COMMISSION ON ALCOHOL AND OTHER DRUGS 2021 ACCOMPLISHMENTS

2021 was another very difficult year, especially for those in our community who were struggling with substance abuse issues, as well as those that served them. Notwithstanding the problems posed by Coronavirus shutdowns, the Commission maintained a full Virtual meeting schedule, working to address our strategic priorities on a range of issues to assist community members afflicted with Substance Use Disorders. I want to express my deep appreciation and thanks to all our Commissioners who extended themselves to meet their Commission commitments throughout this year and our County support staff liaison, Ronae Harrison who made all of our work possible and my job easier. We worked hard to educate ourselves and advise the Board of Supervisors with input from a wide range of sources, from Dr. Barbara Ferrar, District Attorney George Gascon, Judge Peter Espinoza, Mental Health’s Dr. Jeremy Martinez, Gail Parker of the DEA, Dr. Mark Ryan, Kat Parker, Executive Director of LA City Dept. of Cannabis Regulation and of course, Dr. Gary Tsai, Michelle Gibson and Dr. Tina Kim of SAPC for their continuous source of valuable information, insight and perspective. We ended our year with a Roundtable Discussion with the Health Deputies from all 5 Supervisorial Districts. We are currently in conversations with the LA County Commission on Disabilities concerning possible collaborative efforts. In addition to this we are starting conversations with the Mental Health Commission as well, since one of our members is serving on that commission also. Our Sub-Committees, Policy and Planning, led by Chair Deena Duncan and Education and Prevention led by Chair Cruz Baca, have been invaluable this year in opening new and important avenues of discussion and tracking legislation that affects key issues that our Commission’s strategic priorities aim to address. We look forward to a hopeful future, where we can put the Coronavirus behind us and can focus all our resources on making progress against the many substance abuse issues facing the County. Thank you for the opportunity to serve. Lou La Monte Chair